引导性骨再生模型及其影响因素的骨形态计量学研究

Histomorphometric evalultion of guided bone regeneration

本实验应用骨形态计量学方法研究了引导性骨再生模型中膜管内、外两种不同的成骨过程的特性，并计量分析了去除外骨膜与去除骨髓对于这两种成骨过程的影响。３６只新西兰兔，分成去外骨膜组和去骨髓组，每组分２周、６周、１２周三个时间段。对照侧手术过程：于兔右侧桡骨造成１０ｍｍ骨缺损，以硅胶管套于缺损两端外骨膜外。去外骨膜侧为另去除桡骨缺损两端外骨膜各１０ｍｍ，去骨髓侧为另以骨水泥封堵缺损两端髓腔。标本做非脱钙骨切片，应用图像分析方法测量平均骨体积、矿化沉积率、四环素双标占单标比例、破骨细胞占骨小梁缘长比例四种指标。结果１骨髓对膜管内成骨过程起决定作用；２去除外骨膜对膜管内成骨过程无影响；３膜管外成骨过程的特点为出现早、停止生长早，再生骨组织速度快、量大；４膜管内成骨过程特点为具有持久骨再生能力，再生骨组织来源受到限制。

Two processes of bone regeneration in guided bone regeneration was evaluated by histomorphometry. One process was in the tube, another was out of the tube.10mm long segmental defects were created in the diaphyses of both radii in 18 rabbits. On the control side, the defects were covered with a silicone membrane shaped as a tube. On the contralateral side,10mm periosteum of both ends of the diaphyses were stripped or marrow cavities of both ends were blocked by cement. Six rabbits were killed 2,6 or 12 weeks after treament. Undecalcified sections were prepared for histologic examination and histomorphometric evaluation. We would conclude that these two bone regeneration processes are different. The process outside the tube is resemble to external callus, while the process inside the tube is resemble to the process of medullary callus, which is not an evanescent burst of activity but it may continue for months in pursuit of its goal.Bone marrow plays a critical role in bone formation inside the tube; while, periosteal stripping has no effect on bone formation in the tube.